Synovial chondromatosis of the shoulder: imaging findings

Abstract

ResumoSynovial chondromatosis is a benign condition characterized by synovial proliferation and metaplasia, with development of cartilaginous or osteocartilaginous nodules within a joint, bursa or tendon sheath. In the shoulder, synovial osteochondromatosis may occur within the glenohumeral joint and its recesses (including the tendon sheath of the biceps long head), and in the subacromial-deltoid bursa. Such condition can be identified either by radiography, ultrasonography or magnetic resonance imaging, showing typical features according to each method. Radiography commonly shows ring-shaped calcified cartilages and periarticular soft tissues swelling with erosion of joint margins. Ultrasonography demonstrates hypoechogenic cartilaginous nodules with progressive increase in echogenicity as they become calcified, with development of posterior acoustic shadow in case of ossification. Besides identifying cartilaginous nodules, magnetic resonance imaging can also demonstrate the degree of synovial proliferation. The present study is aimed at describing the imaging findings of this entity in the shoulder.

Condromatosis sinovial: una causa poco frecuente de omalgia. Revisión de la literatura a propósito de un caso

“…Esta forma primaria afecta a 1/100.000 personas, siendo, en la mayoría de los casos, una afectación monoarticular (3) . Nuestro caso presenta características atípicas en relación con esta patología, ya que afecta más frecuentemente a hombres de entre 30 y 50 años, siendo la rodilla la articulación más involucrada (70% de los casos), seguida de la cadera y el hombro con porcentajes variables según las series (3,4) . En cuanto a la forma secundaria, se relaciona con la artropatía degenerativa, osteonecrosis, osteocondritis disecante, neuropatía, traumatismos o la artritis reumatoide, siendo generalmente poliarticular y afectando a pacientes de mayor edad (2,5) .…”

“…Por eso, es importante realizar una sinovectomía amplia. Aunque el riesgo de transformación maligna es bajo, con tasas en torno al 5% (4) , hay que sospecharla en casos de empeoramiento clínico asociados a osteolisis en las pruebas de imagen.…”

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“…Heel pain is a very common complaint in orthopedic offices. The Brazilian radiological literature has recently been concerned with the relevant role played by imaging methods in the improvement of the diagnosis in the musculoskeletal system ( 1 - 15 ) .…”